Musculoskeletal Trauma & Orthopedic Surgery

Question 1

What is the most common cause of musculoskeletal injury ? (4)

Answer 1

Fracture
Dislocation
Subluxation
Soft tissue injury

Question 2

We want to teach our patients the importance of reducing the risk of musculoskeletal injury and morbidity from these injuries why?

Answer 2

Because the cost, pain, and disability can be expensive and potentially lead to further complication

Question 3

Some ways we can help protect our patients is by following safety precautions
Give me 2 examples for car
Give me 2 examples of exercise
Give me an example for construction

Answer 3

Wearing seat & following speed limit
Warm up before exercise &
Protective athletic equipment

Proper safety equipment

Question 4

Prevention of musculoskeletal problems in older adults
How would we do this?

Answer 4

Using ramps instead of steps
No rugs
Treat pain & discomfort
Cane/walker
Exercise
Wear good shoes
Change position
Avoid walking on uneven/wet surfaces

Question 5

What are the 4 related traumatic injuries for soft tissue?

Answer 5

Sprains
Strains
Dislocations
Subluxations

Question 6

What is a sprain?
What type of motions?
How do we stage a sprain? (1-3)

Answer 6

Injury to the ligaments surrounding a joint

Caused by wrenching or twisting motion

1- mild, tear a few fibers
2- moderate, partial tear with involved tissue
3 - complete tear of ligament

Question 7

What is a strain?
How to you stage a strain 1-3?

Answer 7

Excessive stretching of a muscle & tendon

1- mild slightly pulled muscle
2 - moderate, torn muscle
3 - severe, ruptured muscle

Question 8

What are manifestations of sprains and strains ? (4)

Answer 8

Pain
Edema
Decrease function
bruising

Question 9

How do we diagnosis a sprain and strain?

Answer 9

X- ray machine

Question 10

What are complications of strains and sprains? (5)

Answer 10

Avulsion fracture
- ligament pull loose a fragment of bone

Subluxation

Dislocation

Hemarthrosis
- bleeding into joint

Surgical repair

Question 11

Most of the time sprains and strains can be treated and are self limited, why?

Answer 11

Because we can easily rest and stay off our injury

Question 12

What is the acute care we want to give to sprains and strains?
Acronym

And one more not apart of the acronym

Answer 12

RICE
rest
Ice - 24-48 hours & stop 20-30mins
Compression - bandages
Elevate - above the heart

Analgesia

Question 13

Should ice go directly on the skin? Why or why not?

Answer 13

No because they could get frost bite if people have no sensation

Question 14

If you’re putting a compression on, how many fingers should fit?

Answer 14

2 fingers

Question 15

Emergency acute soft tissue injury
What is the initial goal?
(2)

Answer 15

Intact nervouvascular sensation
And not dislocated & fractures

Question 16

What is dislocation?

Answer 16

Complete displacement or separation of the articulate surfaces of the joint

Question 17

What is subluxation?

Answer 17

Partial or incomplete displacement of the joint surface, symptoms are less severe

Question 18

Dislocations typically result from what?
Examples?

Answer 18

Forces on the joints that disrupt the surrounding soft tissue support structures

Thumbs, elbow, shoulder

Question 19

What are symptoms of dislocation and subluxation? (5)

Answer 19

Deformity
Pain
Tenderness
Loss of function
Swelling

Question 20

What are major complications of dislocation & subluxation? (2)
Define them

Answer 20

Intraarticular fractures ( open joint )
Avascular necrosis ( bone cell death from blood supply )

Question 21

How do you diagnosis dislocation & subluxation (2)

Answer 21

X ray
Aspiration
( withdrawing fluid from the joint ^ )

Question 22

Dislocation is a what emergency?
Why?
You can get what syndrome?

We might want to realignment dislocation
With what 2 surgeries?

And follow patients by?

Answer 22

Orthopedic
Risk for vascular injury & Avascular necrosis
Compartment syndrome

Closed reduction ( anesthesia )
Open reductiion

Imbolizes them

Question 23

What are the nursing care for dislocation and subluxation? (4)
And what other things should we do (3)

Answer 23

Neurbascular assessment
Immbolization of joint
Pain management
Joint protecting

( gentle rom )
( rehabilitating )
( precent repeating dislocation )

Question 24

What is a neurovascular assessment? (5)

Answer 24

Normal sensation
Skin is pink
Warm
Pulses
Pain is not abnormal related to injury

Question 25

What is repetitive strain injury and cumulative trauma disorder?

Answer 25

Injured from prolonged force or repetitive movements and awkward postures

Question 26

What are examples of Repetive strain injury? (2)

Answer 26

Tennis elbow
Carpal tunnel syndrome

Question 27

Repetitive strain injury will have (4)

Answer 27

Inflammation
Swelling
Pain in muscle
Nerve pain

Question 28

What are the 3 symptoms of repetition strain injury?

Answer 28

Pain
Weakness
Impaired motor function

Question 29

How do we prevent repetitive strain injury?

Answer 29

Education & ergonomics ( science promote efficiency and safety )

Question 30

How do we do treatment for repetitive strain injury? (3)

Answer 30

NSAIDs
Cold therapy
Physical therapy

Question 31

What is carpal tunnel syndrome?
What are the 2 signs we can test for this and define them

Answer 31

Compression of median nerve

Tinel sign
- percussion over the medical nerve

Phalen sign
- back to back hands

( burning or tingling )

Question 32

What is rotator cuff?
How do you tell this?

Answer 32

Damage to one or more of the 4 muscles that stabilize the shoulder joint

Sudden addiction while arm is abducted

Question 33

What is bursitis ?

Answer 33

Inflammation of bursa
( sac of fluid but this sac of fluid will burst during injury & inflames )

Question 34

What is meniscus injury?

Answer 34

Commonly associated with sports injures
Ligament sprains

Question 35

What is anterior cruciate ligament injury?

Answer 35

Most commonly sports related knee injury
( think of tear acl )

Question 36

What is the management of all the repetitive injuries just mentioned
(6)
Anterior cruciate ligament
Bursitis
Carpal tunnel
Rotator cuff
Meniscus injury

Answer 36

Prevention
Rice
Immobilizer
PT
Steroid injections
Surgery